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原发性闭角型青光眼且无视网膜病变的糖尿病患者原发性小梁切除术的长期疗效

Long-Term Outcomes of Primary Trabeculectomy in Diabetic Patients without Retinopathy with Primary Angle-Closure Glaucoma.

作者信息

Liu Jian, Zhang Miaomiao, Li Bin, Wang Jianrong

机构信息

Department of Ophthalmology, The Second People's Hospital of Jinan, No. 148 Jingyi Road, Jinan 250001, China.

出版信息

J Ophthalmol. 2017;2017:7947854. doi: 10.1155/2017/7947854. Epub 2017 Feb 26.

Abstract

. To evaluate primary trabeculectomy with adjunctive mitomycin-C (MMC) in diabetic patients without retinopathy with primary angle-closure glaucoma (PACG). . This is a retrospective case series comparison. . This retrospective trial compared outcomes of 88 eyes that underwent trabeculectomy in patients with diabetes mellitus (DM) without retinopathy and in 97 patients without DM. . In this study, the intraocular pressure (IOP), visual acuity, visual field, and postoperative complications were compared between the two groups. Qualified surgical success is defined as an IOP between 6 and 18 mmHg with or without topical antiglaucoma medication. . After a follow-up of 5 years, the IOP decreased from a mean basal IOP of 27.8 ± 7.3 mmHg to 15.0 ± 5.6 mmHg in the DM group and from 27.3 ± 6.0 mmHg to 12.4 ± 5.3 mmHg in the control group. The mean number of antiglaucoma medications was 3.4 ± 1.3 and 3.3 ± 1.2 preoperatively ( = 0.587) whereas it was 1.7 ± 1.5 and 1.1 ± 1.4 at the 5-year follow-up ( = 0.049). The 5-year qualified surgical success rates were 42.9% and 65.4% for both groups ( = 0.046; log-rank test). Encysted blebs were seen in 21 (23.9%) patients in the DM group and in 12 (12.4%) patients in the control group ( = 0.041). . PACG patients with DM without retinopathy undergoing primary trabeculectomy with MMC may have a lower long-term surgical survival rate compared with patients without DM.

摘要

评估在无视网膜病变的糖尿病患者中,小梁切除术联合丝裂霉素C(MMC)治疗原发性闭角型青光眼(PACG)的效果。这是一项回顾性病例系列对照研究。该回顾性试验比较了88例无视网膜病变的糖尿病(DM)患者行小梁切除术的眼部情况与97例非糖尿病患者的情况。在本研究中,比较了两组的眼压(IOP)、视力、视野及术后并发症。合格的手术成功定义为眼压在6至18 mmHg之间,无论是否使用局部抗青光眼药物。随访5年后,DM组眼压从平均基础眼压27.8±7.3 mmHg降至15.0±5.6 mmHg,对照组从27.3±6.0 mmHg降至12.4±5.3 mmHg。术前抗青光眼药物的平均使用数量在两组分别为3.4±1.3和3.3±1.2(P = 0.587),而在5年随访时分别为1.7±1.5和1.1±1.4(P = 0.049)。两组的5年合格手术成功率分别为42.9%和65.4%(P = 0.046;对数秩检验)。DM组21例(23.9%)患者出现包裹性滤泡,对照组12例(12.4%)患者出现包裹性滤泡(P = 0.041)。与非糖尿病患者相比,无视网膜病变的DM患者行小梁切除术联合MMC治疗PACG的长期手术成功率可能较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/133b/5346389/80468d13a0c4/JOPH2017-7947854.001.jpg

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